Wednesday, January 7, 2009

Old Age in Cambodia

We heard about the 189 deportees from the U. S. back to Cambodia (see story below). The problems these people pose to the country as a whole pale compared to the problems prevalent in Cambodia today due to a complete lack of even the most basic social assistance programs. We are appalled when we read about Western countries having a poverty rate of about 15%, e. g. industrialized countries like the U. S., France, or Germany. And those countries do have a system in place to assist people in need, some better, some worse, as in the U. S.

But it is outright distressing when one comes to realize what old people face in this country. Of course, it has to do with poverty, and I am sure a lot of pundits will point to the inequality of the system, in which the officials line their own pockets, the rich drive around in Lexuses and Landrovers, while the poor don’t know where to find their next meal.

The social fabric of Khmer society the way I have come to know it is still the cohesion of the family. The family is the nucleus of every society, both Western and Asian. But whereas in the West the state has taken over some of the traditional roles and functions formerly performed by the family, the family-based system of support is still very much the norm in Cambodia, and in all of Asia for that matter. We don’t need to dwell on why most Asian countries haven’t followed the industrialized world’s example in the social sector. I just want to highlight one old person’s life from my personal experience to show how much needs to be done in Cambodia in that field. There is so much griping going on about the various shortcomings and weaknesses of this country, e. g. human rights, workers’ rights, sexual exploitation because they make for so much better headlines that the lives of the elderly seemingly are largely forgotten.

Ohm Hen, let’s use the traditional Khmer form, is over 70 years old. As is often the case she doesn’t know her exact age. She was born in a village in Kratie province. Basically the entire village population is related to one another on account of the traditional form of arranged marriages. Oftentimes, families don’t look very far to find spouses for their children. Cousins, direct or once removed, are considered prime candidates. People are sure of their bloodlines and everything sort of stays in the family.

This is why Ohm Hen is also a distant aunt of my wife’s. Ohm Hen married young, had one child, which she lost because of a childhood disease. Unfortunately, in her thirties she also broke her back in a fall leaving her with a hunchback as doctors then did not set the broken bones. She couldn’t afford treatment in a hospital. She and her husband made it through the Pol Pot years, and even adopted a girl so they would have someone to take care of them in old age. As in almost all Asian countries this is still the main reason for people having numerous children. That doesn’t mean they don’t love them any less than their Western counterparts. The more children you have the higher the likelihood that they can afford a normal life in old age.
Ohm Hen was not blessed this way. Her husband died some twenty years ago, leaving Ohm Hen with a young adopted girl to fend for herself. Times were hard and it was mostly an uphill battle. Sadly enough, the girl’s life didn’t turn out so well either. She also had a baby boy at a very young age and did not get married to the father. The Pol Pot and subsequent Communist years had markedly affected traditional family values in such a way that taking responsibility was not an option for many a young father. So this young man also took the easy way out and left his wife, his baby, and his responsibility behind. He up and left them.

Soon after the daughter thought she might make a better living elsewhere and left her mother, leaving her baby there. Ohm Hen was back to square one, as we like to say. But she took care of the boy and raised him to be a poor but honest young man. Though the mother occasionally came back to live with them when she had again fallen on hard times, she always felt the urge to leave for greener (?) pastures. Who knows what she was doing during those times. The last time she left was to escape from her creditors. She had borrowed heavily from neighbors. When the pressure became too strong she skedaddled.

In her later years Ohm Hen had developed severe hip joint pain due to wear of the cartilage, which in the last year or so had rendered her practically immobile. She was spending her days by herself. She was still able to move around a little, cook her food, but she could no longer go to the market. For the longest time her grandson took care of her. But once he was 18 he found a job as a driver of one of those minibuses that serve as the main means of transportation for the poor people. The problem was he did not have a driver’s license and whenever he saw police he took a detour to avoid being stopped and hassled for some bribe. He made about $70 a month but with his living expenses, like rent and food, there wasn’t anything left over to support his grandma.

Ohm Hen scraped together what she could mostly from relatives. She has 4 sisters, but all of them with families of their own, and none of them in a position to either provide shelter or support for Ohm Hen. She practically lived on handouts. Before last year she hadn’t seen her daughter in 3 years. Her living conditions are outright depressing. They had built a ram-shackle wooden hut on a river-bank on the outskirts of Phnom Penh very close to one of the new ring roads that have been built. The city government might come any day to tell them they had to move as it needed the land for further development. Needless to say, Ohm Hen does not have any right to the place. She is a squatter.

When the situation with her hip got so bad she couldn’t move any more she sought help from her sisters. But none of them could offer any. At one point late last year her son had made contact with his mother again. It turned out she had remarried. Her husband, an amputee, was doing some business as a middleman in some real estate deals in the province. They finally took her in. Her grandson moved with her and continued working as a driver of a minibus running a daily service from the village to Phnom Penh. After a couple of months the pain got so bad again she needed to see a doctor. So she moved back to her ram-shackle hut. Apparently she also had a falling out with her daughter again, since times had gotten tough with the real estate business melting down like snow in sunshine. Her daughter was facing her own problems again.

So here she was. Her grandson, although only 21, had gotten married too. Both his wife and he moved into the hut with Ohm Hen. The wife managed to get a job in a garment factory. So they had at least some income. But the grandson had lost his job. The wages of a factory worker isn’t normally enough for one person, let alone three. And there is certainly no budget for doctor’s expenses. To make matters even worse, the wife is already pregnant.

Nobody was able to help her with her hip pain. Anyone who has ever been to the Calamette hospital in Phnom Penh knows how it works. An obviously poor person in pain comes in. That person is just left on a stretcher for hours. The doctors know that person probably can’t pay the fees so they just leave them there. After something like 6 to 8 hours they look at them, write a prescription, and that’s that. Poor people don’t have the money to pay for the medication anyway. So where is the help? This happened to Ohm Hen. And this happens to thousands after thousands of people.

Water storage

The Kitchen

'Prime Location'
The Living and Bedroom

One of Ohm Hen’s sisters is in similar situation. They are in their late sixties. Although the husband had worked all his life he doesn’t have any reserves for his retirement. They have one son whom they gave up for adoption to a Canadian couple before the Pol Pot years, thinking this will give him a good education and job in Canada so he could support them in old age. They also adopted a girl. Once the son had grown up he did his duty and sent money every month. He even started his own business in Canada, which afforded him a good life style.

Meanwhile the daughter of that sister, let’s call her Ohm Sim, had gotten married but they just lived an average life, which in Cambodia means you may make enough to barely live on. The economy in Canada suffered just like the rest of the world in 2008. So the son wasn’t able to support his parents any more. He used to send them $100 every month – good money for poor people. Now that wasn’t coming any more. Ohm Sim has a heart condition. This can’t be treated either for lack of money.

What are these people supposed to do? The family can’t help; they are poor themselves. The government doesn’t help; they neither have the money, nor any program, nor apparently not even the will to bring about any change for the millions of poor people in the country. Roughly 70 % live in rural areas and the majority of those exist on subsistence farming. At least they have enough to eat. But when it comes to health care they turn to traditional medicine with questionable results, or just leave illnesses untreated, dying an early death. City dwellers are a different matter altogether as the recent dramas involving city squatters has shown. They used to scrounge together enough money so they could even afford a moped.

China even has it written in their constitution that the family must support their old parents. The Cambodian constitution is rather hazy on the subject.

Article 47,2 says: Children shall have the right to take good care of their elderly mother and father according to Khmer traditions.

A right is inherently passive in nature so the word is ill-chosen in this context. But the Khmer word in the original text is more inclusive. Nonetheless, this is easier said than done in Cambodia. If the children don’t have the means, how can they take good care of their elderly parents? It may run against their deep-rooted convictions and Buddhist traditions, but the government has a social responsibility towards their poor and elderly.

But tragically, news headlines rarely touch on this very important social aspect. It deserves much more attention than what this deep-running problem is getting now. The public conscience seemingly doesn’t want to deal with it. But it doesn’t go away by simply ignoring it; it only gets worse.

Footnote: When this came to my attention we started to help Ohm Hen by paying for her doctor’s visits, medication, and food. We are at this time looking for a new place to stay. We also occasionally give some money to Ohm Sim.

No comments: